UW3 (18 Env&Poison)

Question 1

Food consumption

Flushing
Palpitation
Throbbing headache
Abd cramp
Diarrhea
Oral burning
Bitter taste

• Diagnosis?
• Prognosis?

Answer 1

• Scombroid

* Self Limit

Question 2

Infant
Constipation
Poor feeding/suck
No gag reflex
Strength ↓

• Diagnosis?
• Treatment?

Answer 2

Botulism

1) Airway support
2) Botulism IVIG  Full recovery
3) Support (Laxative / NG feed)

Question 3

Lead screening

Test?

• No treatment?
• Succimer / DMSA?
• Dimercaprol + EDTA?

Answer 3

• Confirm with venous Pb

• Pb 5- 45 / Asymptomatic
• Pb 45-70 / Symptomatic
• Pb > 70

Question 4

Heat Stroke (treatment) 3

Answer 4

1) Remove from heat
2) Stabilize
3) Evaporative cooling

Question 5

Salicylate / Aspirin OD

Treatment? 3

Answer 5

1) HCO3 (alakalize urine/plasma)
2) D5w + Activated Charcoal
3) Dialysis

Question 6

OrganoPhosphate Poison

Treatment? 3

Answer 6

• Oxygen / Intubation
• Atropine + Pralidoxime
• Activated charcoal

Question 7

Ethylene Glycol Ingestion

• Symptoms?
• Treatment?

Answer 7

• AGAP-MA
• Kussmal breathing (deep rapid)
• Ataxia
• Nystagmus

• Fomepizole (competitive inhibitor @ ADH)

Question 8

Herbal Supplement
Use & effects?

1) Ginko biloba
2) Ginseng
3) Saw Palmetto
4) Black Cohosh
5) St John’s wort
6) Kava
7) Licorice
8) Echinacea
9) Ephedra

Answer 8

1) Memory - Bleed ↑
2) Mental performance - Bleed ↑
3) BPH - Gi upset / Bleed ↑
4) Post Menopausal - LFT ↑
5) Depression / Insomnia - Hypertensive crisis / Serotonin syndrome/ AntiCoag INR ↓
6) Anxiety / Insomnia - LFT ↑
7) Stomach ulcer / Bronchilitis / Viral infection - Hypertension / K ↑
8) Cold & Flu - Anaphylaxis @ asthma
9) Cold & Flu / Weight loss / Performance – Hypertension / Arrhythmia / MI / Stroke / Seizure